- Is It Possible?
Can you breastfeed with rheumatoid arthritis?
- You must always consult your doctor before you start the process.
- RA is not an infectious disease. It cannot be transmitted from a mother to her baby during delivery or through breast milk.
- RA does not affect the quality of your breast milk.
- However, certain medications taken for RA may be secreted in your breast milk. These medicines may cause ill-effects in the newborn. Hence, you need to discuss with your doctor.
- Breastfeeding offers numerous benefits for the mother and her baby. Hence, women with RA are encouraged to breastfeed their newborns wherever possible.
The benefits of breastfeeding include the following:
- Reduces the risk of ovarian and breast cancer in women
- Provides an ideal source of nutrients for the baby
- Develops a bond between the woman and her baby (due to the physical closeness, skin-to-skin touching, and eye contact with the baby)
- Helps mother deal with postpartum blues.
Does breastfeeding help prevent rheumatoid arthritis?
Recent studies have found that longer the history of breastfeeding, less is the risk of rheumatoid arthritis (RA) in the baby. Breastfeeding may protect the baby against RA in later life. Earlier studies suggested that breastfeeding increases the risk of RA in the mother but that might be due to the genetic makeup making the women more likely to get flare after the pregnancy.
For women already affected with RA before their delivery/pregnancy, the first three months after delivery can cause a flare in RA symptoms. However, scientists are still unsure if breastfeeding further increases this risk. Some women report relief in their symptoms after delivery.
A study found that women who breastfed their babies for one to two years exhibited a 20% reduced risk of RA compared with those who did not breastfeed at all. Breastfeeding for at least two years reduced the risk of RA by almost half.
Does breastfeeding make your joints hurt?
Soreness in your joints commonly results from joint tension, muscle tension and fatigue, which are not strangers to breastfeeding mothers. Women with RA slightly more affected with the following issues:
- Flares in rheumatoid arthritis (RA) after delivery are common due to hormonal changes.
- Sitting in an uncomfortable position can make women’s joints hurt more if they have RA and vice versa (RA can make breastfeeding difficult for women due to the painful joints).
Women can avoid joint aches by adopting certain positions that put less pressure on their joints. These can be as follows:
- Reclining positions or side-lying on a bed
- Making use of cushions, pillows, or blankets to support a mother’s arms and/or baby
- Taking the support of a footstool or other forms of support
- Consulting an occupational therapist will help new mothers to choose the best positions for breastfeeding.
Which drugs are safe for breastfeeding women with rheumatoid arthritis?
Some of the medicines are found to be excreted in the breast milk, but their quantities differ. Women should pump their milk just before they take medicines so that the amount of medicine in the milk is negligible There are several medications prescribed for rheumatoid arthritis (RA) that are considered safe for breastfeeding women. These include the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and paracetamol
- Prednisone in low doses (20 mg/day) (At higher doses, women should pump and discard breast milk that is produced during the first four hours after taking the tablet)
- Hydroxychloroquine (HCQ)
- Aspirin in low doses (81 mg/day)
- Intravenous immune globulin
- Tumor necrosis factor (TNF) inhibitors such as etanercept, infliximab or adalimumab have limited safety data and should be avoided wherever possible.
Certain drugs used for RA are generally avoided during breastfeeding. Some of these include the following:
Reports suggest that certain drugs such as Rituxan (rituximab), Kineret (anakinra), and Orencia (abatacept) have shown no adverse effects on the baby during breastfeeding. However, there is a lack of long-term safety data, and doctors prescribe these drugs with caution. Hence, only the doctor can decide the most appropriate drug for a breastfeeding woman with RA.
Health Solutions From Our Sponsors
Silman A, Kay A, Brennan P. Timing of pregnancy in relation to the onset of rheumatoid arthritis. Arthritis Rheum 1992; 35:152.
Guidelines for monitoring drug therapy in rheumatoid arthritis. American College of Rheumatology Ad Hoc Committee on Clinical Guidelines. Arthritis Rheum 1996; 39:723.
Rheumatoid Arthritis and Pregnancy. Available at: https://www.arthritis.org/health-wellness/healthy-living/family-relationships/family-planning/rheumatoid-arthritis-and-pregnancy
Breastfeeding Helps Avoid Rheumatoid Arthritis. Available at: https://www.webmd.com/rheumatoid-arthritis/news/20041104/breastfeeding-helps-avoid-rheumatoid-arthritis#:~:text=Nov.,woman's%20risk%20for%20rheumatoid%20arthritis.
Akasbi N, Abourazzak FE, Harzy T. Management of pregnancy in patients with rheumatoid arthritis. OA Musculoskeletal Medicine. 2014;2(1):3.
Wambach and Spencer, Breastfeeding and Human lactation 6e, 2020 p 530
Breastfeeding Answers Made Simple, Mohrbacher, 2010, p 766
Dr Jack Newman’s Guide to Breastfeeding, 2014, p. 234
Olsen et al, Hormones, Pregnancy, and Rheumatoid Arthritis, J Gend Specif Med, 2002
Hampl and Papa, Breastfeeding-related onset, flare, and relapse of rheumatoid arthritis, Nutrition Reviews, 2009
Brennan and Silman, Breastfeeding and the onset of rheumatoid arthritis, Arthritis Rheum. 1994
Maternal Autoimmune Disorders and Breastfeeding, Breastfeeding USA, Shimamto, 2014
Jacobson et al, Perinatal characteristics and risk of rheumatoid arthritis, British Medical Journal, 2003
Raising a Baby When You Have RA. Available at: https://www.webmd.com/rheumatoid-arthritis/features/ra-raising-baby
Breastfeeding Overview. Available at: https://www.webmd.com/parenting/baby/nursing-basics#1
Positions for breastfeeding. Available at: https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Positioning-Your-Baby-For-Breastfeeding.aspx
Drugs and Lactation Database (LactMed) Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Top Breastfeeding With Rheumatoid Arthritis Related Articles
11 Home Remedies for Rheumatoid ArthritisRheumatoid arthritis (RA) is a long-term disorder that progressively affects many parts of the body. Home remedies, diet, and lifestyle changes can help reduce pain and discomfort associated with RA alongside medical treatment. Home remedies alone cannot effectively treat RA or prevent the progression of the disease.
Can Rheumatoid Arthritis Be Caused by Stress?Rheumatoid arthritis is a chronic inflammatory joint condition and an autoimmune disease. At times, treatment can make rheumatoid arthritis symptoms (pain and swelling) disappear for a while. This symptom-free period is referred to as “remission.” A remission is followed by the reappearance of symptoms and this period is known as a flare-up. Research says that rheumatoid arthritis can be caused by stress.
Do Inverted Nipples Make Breastfeeding Difficult?Inverted nipples can make breastfeeding difficult for nursing mothers. Learn how to identify an inverted nipple, why inverted nipples can make it difficult to breastfeed, and what you can do to treat inverted nipples.
Duexis (ibuprofen and famotidine)Duexis (ibuprofen and famotidine) is a prescription medicine used to treat the symptoms of Rheumatoid Arthritis and Osteoarthritis. Duexis may be used alone or with other medications. Serious side effects of Duexis include potentially fatal heart attack, stroke, or gastrointestinal (GI) adverse events (bleeding, ulceration, and perforation of the stomach or intestines).
How Serious Is Rheumatoid Arthritis?Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the joints and other body parts, such as the skin, eyes, lungs, heart and blood vessels. RA is an autoimmune disorder, a condition where the body’s immune system attacks its own tissues. If not diagnosed early and appropriately treated, RA can lead to permanent deformities, disabilities and serious systemic complications.
16 Early Rheumatoid Arthritis (RA) Symptoms and SignsEarly RA symptoms and signs vary differently from person to person. The most common body parts that are initially affected by RA include the small joints of the hands, wrists, and feet, and the knees and hip joints. Joint inflammation causes stiffness. Warmth, redness, and pain may vary in degree.
RA QuizHow is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid Arthritis (RA) Quiz to rest your RA IQ.
Famous Faces of RALearn more about the famous faces of rheumatoid arthritis such as Lucille Ball, Glenn Frey, and more.
Sandimmune (cyclosporine)Sandimmune (cyclosporine) is used with adrenal corticosteroids to prevent organ rejection after a kidney, liver, or heart transplant surgery. Sandimmune is also used to treat people with severe rheumatoid arthritis or severe psoriasis. Side effects of Sandimmune include renal dysfunction, tremor, hirsutism, hypertension, and gum hyperplasia.
What Are the Four Stages of Rheumatoid Arthritis?Rheumatoid arthritis is a chronic inflammatory disease characterized by pain and inflammation in joints, typically of the hands and feet. It is an autoimmune disease in which the immune system of the body attacks its own healthy cells, resulting in inflammation of the membrane lining the joints and damage to joint tissue.